Sarcopenia in the prognosis of cirrhosis: Going beyond the MELD score

Table 2 Clinical impact of sarcopenia on mortality in cirrhosis patients

Ref.	n	Unit of measure	Level of measure	Factors associated with survival (HR, 95%CI)	Survival among sarcopenic and nonsarcopenic patients	Cause of death
Durand et al[7]	562	TPMT/height, mm/m	umbilicus	MELD score (1.2, 1.14-1.27) TPMT/height (0.86, 0.78-0.94) in MELD-era cohort
Hanai et al[8]	130	SMI, cm2/m2	L3 vertebrae	CTP class B (2.39, 1.07-5.95) CTP class C (5.49, 2.11-15.12) BCAA (0.38, 0.19-0.79) Sarcopenia (3.03, 1.42-6.94)	The 1-, 3-, and 5-yr survival rates in patients with sarcopenia and nonsarcopenia were 85% and 97%, 63% and 79%, and 53% and 79%, respectively (P = 0.01)	No significant difference was seen in cause of death between patients with and without sarcopenia
Kim et al[9]	65	PMTH, mm/m	L4 vertebrae	PMTH (0.81, 0.68-0.97)	The median survival was 16 (95%CI: 7-26) mo in patients with PMTH ≤ 14 mm/m The 1- and 2-yr mortality rates in patients with PMTH ≤ 14 mm/m and PMTH > 14 mm/m were 41.6% and 2.6%, and 66.8% and 15.2%, respectively (P < 0.001)
Meza-Junco et al[43]	116	SMI, cm2/m2	L3 vertebrae	Serum Na (0.89, 0.81-0.98) MELD (1.06, 1.01-1.12) CTP (2.39, 1.43-4.01) TNM stage (2.03, 1.45-2.84) Sarcopenia (2.20, 1.21-4.02)	The median survival was 16 ± 6 mo vs 28 ± 3 mo in sarcopenic patients compared to nonsarcopenic (P = 0.003) The 6-mo, and 1-yr survival rates in patients with sarcopenia and nonsarcopenia were 67% and 90%, and 52% and 82%, respectively	No significant difference was seen in the frequency of sepsis-related death between patients with and without sarcopenia (12% vs 4%, P = 0.2)
Montano-Loza et al[10]	112	SMI, cm2/m2	L3 vertebrae	CTP (1.85, 1.02-3.36) MELD (1.08, 1.03-1.14) Sarcopenia (2.21, 1.23-3.95)	Median survival was 19 ± 6 mo vs 34 ± 11 mo in sarcopenia patients compared to nonsarcopenic patients (P = 0.005) The 6-mo and 1-yr survival rates in patients with sarcopenia and nonsarcopenia were 71% and 90%, and 53% and 83%, respectively	The rate of sepsis-related death was significantly higher in sarcopenic patients than nonsarcopenic patients (22% vs 8%, P = 0.02)
Tandon et al[11]	142	SMI, cm2/m2	L3 vertebrae	Age (1.06, 1.01-1.10) MELD (1.13, 1.09-1.19) Sarcopenia (2.36, 1.23-4.53)	The 1-, 2-, and 3-yr survival rates in patients with sarcopenia and nonsarcopenia were 63% and 79%, 51% and 74%, and 51% and 70%, respectively (P = 0.04)	Rates of sepsis-related death: 47% in sarcopenic patients vs 31% in nonsarcopenic patients (P = 0.48)

BCAA: Branched chain amino acid; PMTH: Psoas muscle thickness by height.